Fetal movements are a reliable indicator of fetal well-being. Any maternal reporting of a change in fetal movements should be taken seriously and assessment arranged as soon as possible.

 RPA Women and Babies - pdf Decreased fetal movements guidelines  (117 KB)
 Movements matter - comprehensive suite of resources for both health professionals and consumers developed by the Centre of Research Excellence in Stillbirth. Translated information also available 
 Maternity - Decreased Fetal movements in third trimester - NSW Health Guidelines

  pdf Diagnostic Testing for Hyperglycaemia in pregnancy (504 KB)  - resource which includes defining risk, screening protocol, interpreting results, postnatal follow-up and pre-pregnancy assessment
  pdf Glucose Tolerance Test (GTT) Instructions (149 KB)  - patient instruction for GTT testing
 ADIPS - Australian Diabetes In Pregnancy Society- Resources for both health professionals and patients

Early identification of women experiencing psychosocial problems and mental health conditions in the perinatal period it important so they can recieve timely support and care. 

  pdf Mental Health Care in the Perinatal Period - Australian Clinical Practice Guideline (681 KB)  - Centre of Perinatal Excellence (COPE)
 COPE Centre for Perinatal excellence - provides resources for both health professionals and consumers
 Screening and assessment tools : Psychosocial risk assessment (ANRQ/PNRQ) & Assessment of depression and anxiety (EPDS. Includes D&A and D&FV questions 
  pdf Looking after your perinatal mental health (611 KB)  - Information for patients
 beyondblue - provides access to a variety of information regarding perinatal mental health

Clinical Services
Psychological Support Services (PSS)

PSS provides FREE short term face-to-face psychological services to people living in the CESPHN region. Priority groups include women experiencing perinatal depression from conception to 12 months after birth.

For more information visit our PSS page

St John of God Medical Centre 
Free Medicare fund Psychiatrist service for women in the perinatal period that cannot afford a consult with a private psychiatrist.
The clinic provides short term assessment, therapy, and treatment plan and the woman is referred back to the GP for ongoing management

For more information and referral processes visit pdf Clinic Information (476 KB) and pdf GP Referral Form  (261 KB)

All women, regardless of age should be counselled and offered the option for screening for chromosomal anomalies.

Antenatal Shared Care GPs can refer women directly to the Fetal Medicine Unit (Phone: 9515 6042 or Fax: 9515 6579) for the following tests:

• Combined First Trimester Screening (cFTS)
• Non-Invasive Prenatal Screening (NIPT)
• Chorionic Villus Sampling (CVS)
• Aminocentesis

Relevant referral forms are required to be completed for referral for these tests.

Timing of procedures 

Procedure	Gestation (wks)
Non- Invasive Prenatal Testing (NIPT)	10 weeks onwards
Combined First Trimester Screening (cFTS)	11+1-13+6
Chorionic Villus Sampling (CVS)	11-13
Amniocentesis	15-19

The Fetal Medicine Unit (FMU) at RPA Women and Babies routinely offers Combined First Trimester Screening (cFTS): ultrasound scan (nuchal translucency and nasal bone) plus biochemistry to pregnant women booking for delivery at RPA Women and Babies and Canterbury Hospitals 

Referral for cFTS: 

• Complete FMU Ultrasound Referral Form (yellow)  
• Complete pdf RPAH First Trimester Screening Pathology Form (157 KB) - advise woman that blood can be collected from 11 weeks until at least 3 days prior  to ultrasound appointment. It should be collected at either RPAH or Canterbury Hospital Pathology Department 
• Provide woman the   pdf First Trimester Screening Patient Information Sheet  (127 KB) which outlines screening test procedure
• Provide relevant Patient Information Brochures     pdf cFTS  (285 KB)      pdf NIPT (537 KB)   pdf CVS & Amniocentesis (358 KB)
• Advise woman that her results will be available at time of U/S appointment (ensuring that blood has been collected prior ) 

Access to Non-Invasive Prenatal Testing (NIPT) will be as a second line screening tool for women at high or intermediate level of risk after cFTS. The NIPT test is not available through Medicare and women will have to fund this test themselves. For further information contact the RPA Genetic Counsellors ph 9515 5080 or Fetal Medicine Unit ph 9515 6042

 Resources

  Patient Brochure- Screening tests for your baby in early pregnancy- NSW Health:  Centre for Genetics Education 
  Patient Brochure- Prenatal testing booklet - NSW Health : Centre for Genetics Education
  RACGP - Genomics in general practice 

 First Trimester Sceening Learning Module: NSW Centre For Genetics: On-line education module 
Search for Certified Operators to perform Nuchal Translucency - RANZCOG Nuchal Translucency: Ultrasound, education and monitoring program

Translated material regarding genetics, prenatal testing and pregnancy are located at the Multicultural Health Communication Service - NSW Health.

  pdf Thyroid Disease Guidelines and referral flowchart (390 KB) : Who to screen, Thyroid Function Test Reference ranges in pregnancy, Referral criteria

Get Healthy in Pregnancy ( NSW Health) - Free telephone-based service to support all women about eat healthily, getting active and maintaining a healthy weight during pregnancy

  Eat For Health ( Australian Government) -  Healthy eating during pregnancy - Consumer brochure

Pregnancy and alcohol  (Australian Government)

 Tobacco smoking and pregnancy ( NSW Health) 

GBS screen should be collected at 34-36 week GP visit .It needs to be collected PRIOR to hospital review at 37 weeks.

The GBS screening LVS can be attended as a pdf patient self- collection (1.65 MB)

Identifying women who are at risk of having a baby with GBS enables treatment to be given intrapartum to prevent transmission of infection to the baby. Discussion about GBS should take place at around 35 weeks gestation so that women have received information about preventive treatment before they go into labour.